Evaluating video-reflexive methods to improve infection prevention and use of personal protective equipment in Australian hospitals

Dr Mary Wyer1,2, Mrs Ruth Barratt1,2, Dr Suyin Hor1,3, Professor Lyn Gilbert1,2

1Westmead Institute For Medical Research, Westmead, Australia,
2Marie Bashir Institute for Infectious Diseases & Biosecurity, Westmead, Australia,
3University of Technology, Sydney, Australia


Staff education and training in some infection prevention and control (IPC) practices, are highly variable and often cursory. Specifically, clinicians’ use of personal protective equipment (PPE), is often poor; potentially leaving them inadequately protected against serious healthcare-associated infections during routine care, or prepared to respond, safely and confidently, to infectious disease emergencies. Our study tests the hypothesis that video-reflexive methods (VRM) will enhance the understanding, performance, recall of and confidence in appropriate use, of PPE in both routine and high-risk settings.


Two controlled trials of VRM in PPE clinician training were conducted at a large Sydney metropolitan hospital. Participants were recruited during existing IPC training and randomly assigned to control or intervention groups. The latter received VRM-modified training, involving videoing of their PPE practice and their reviewing footage, in reflexive sessions. The efficacy of VRM-modified training was tested by comparison of groups for: competency in PPE use, assessed longitudinally by audits in simulated and clinical settings; responses to survey questions on self-efficacy regarding PPE use, and evaluations of training; qualitative analysis of training debrief discussions and post training interviews.


Approximately 200 participants were recruited. Preliminary quantitative and qualitative results suggest that VRM training improves understanding, confidence and recall of effective PPE practice compared to standard training. Participants consistently reported high satisfaction and enjoyment in their evaluations of VRM-training. Learning through group video-reflexive discussion was identified as particularly useful.


The introduction of VRM into IPC training and education can enhance clinicians’ understanding and practice of PPE use.


Mary Wyer is a registered nurse/educator and a postdoctoral researcher located at the Westmead Institute for Medical Research, Sydney. She researches collaboratively with healthcare-workers, patients and families, using video-reflexive ethnography, to understand and improve infection prevention and control practices.

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